Individual
VIOLA FAYE BERTRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
500 PARK ST E, ANNANDALE, MN 55302-3060
(320) 274-2394
Mailing address
1316 ELIZABETH AVE, WILLMAR, MN 56201-3737
(320) 979-1378
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
201488
MN
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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